First Name:             Last Name:  

Address:         

City:   State:    Zip:  

Email:   Phone No.:   

Select the event you wish to participate in:            ? 3 Miler 15 Miler

Are you a current CRRC member? ? Yes No

Sex:      ? Female Male    Age (day of race):     

Waiver:  I agree that by participating in this physical activity, program or event (the "Event"), by using any Event facility or Event premises, I do so at my own risk. I agree I am voluntarily participating in the Event and using Event facilities or premises and assume all risk of injury, illness, damage or loss to me or my property that might result, including without limitation, any loss or theft of personal property.  I hereby consent to medical treatment in the event of injury, accident and/or illness during the Event.  I agree on behalf of myself (and my personal representatives, heirs, executors, administrators, agents and assigns) to release and discharge Columbus Running Company, the Columbus RoadRunners Club, and all Event sponsors from any and all claims or causes of action (known or unknown) arising out of their negligence.    I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability.  By my signature below, I am waiving any right that I (my personal representatives, heirs, executors, administrators, agents and assigns) may have to bring legal action to assert a claim against Columbus Running Company, and all Event sponsors for their negligence. 

By selected "I Agree" below, you are authorizing your signature to be taken electronically, which holds the same value as your written signature.

Waiver Signature:                             I Disagree I AGREE